Objective To observe the effects of central exudative chorioretinopathy(central exudative chorioretinopathy,CEC)treated with blood-activating and stasis-removing Chinese medicines.Methods All 339 cases of central exudative chorioretinopathy with 346 infected eyes were randomly recruited into a treatment group(176 cases with 181 infected eyes)and a control group(163 cases with 165 infected eyes).The treatment group was treated with traditional Chinese medicine by dialectical combination of syndrome and disease,while the control group was treated with conventional treatment.Results The corrected visual acuity was 0.01～1.2 in the treatment group.Of all 181 eyes in 176 patients,76 eyes were cured(41.98%),85 eyes were improved(46.96%),and 20 eyes were ineffective(11.6%),with a total effective rate being 88.94%.BY contrast,in the control group,of all 165 eyes in 163 patients,62 eyes were cured(37.57%),67 eyes were improved(40.60%),and 36 eyes were ineffective(21.83%),with a total effective rate being 78.17%.There was significant difference in the total effective difference between the two groups(U=2.05693,P＜0.05).FFA and OCT were reexamined for the patients in the treatment group three menths after the treatment.The results showed that fluorescein leakage and choroidal neovascularization(choroid al neovascularisation,CNV)lesions disappeared in 76 eyes;fluorescein leakage and CNV lesions relieved in 85 Eyes;fluorescein leakage still existed in 12 eyes;and sear formed in 8 eyes.Conclusion Blood-circulating and stasis-removing Chinese medicines have good effects in promoting subhyaloid hemorrhage and exudation,eliminating retinal oedema,and improving eyesight.

Objective To observe the expression of the unfolded protein response especially the inositol-requiring enzyme-1 (IREl)-Xbp1 signaling pathway, and the change trend of osteogenic markers after inhibition of IREl expression through siRNA interference in osteoblasts exposed to fluoride. Methods Proliferation activity of MC3T3-E1 cells was detected by CCK-8 assay, and 0.0, 0.1, 1.0, 2.0, 8.0, 16.0, 20.0, 32.0, 64.0 mg/L groups were set up. Then representative doses of low, medium and high fluoride (2.0, 8.0, 20.0 mg/L) were selected to treat MC3T3-E1 cells and the expression of the unfolded protein response related genes and osteogenic markers [alkaline phosphatase (ALP), osteocalcin (OCN), Runx2, osterix, binding immunoglobulin protein (Bip), protein kinase-like endoplasmin reticulum kinase ( PERK ) , activated transcription factor 6 (ATF6), Xbp1] was detected by Real-time PCR. MC3T3-E1 cells were transfected with IRE1 siRNA and then exposed to fluoride, and the expression of IRE1 signaling pathway and osteogenic markers was detected by Western blotting and real-time PCR. Results CCK-8 results showed the bidirectional effect of fluoride on the activity of osteoblasts. Compared with the 0.0 mg/L group [1.00 ± 0.01 (d 1), 1.00 ± 0.02 (d 3), 1.00 ± 0.08 (d 7)], the osteoblast activity was significantly enhanced at 2.0 mg/L [1.11 ± 0.02 (d 1), 1.29 ± 0.02 (d 3)], 8.0 mg/L [1.16 ± 0.02 (d 1), 1.44 ± 0.03 (d 3), all P<0.05], while 20.0 mg/L inhibited cell activity [0.83 ± 0.01 (d 1), 0.81 ± 0.01 (d 3), 0.96 ± 0.04 (d 7), all P< 0.05]. Compared with the 0.0 mg/L group [6.86 ± 2.13 (ALP), 4.58 ± 1.52 (OCN), 2.65 ± 0.38 (Runx2), 12.48 ± 3.96 (osterix)], 2.0 mg/L significantly induced the expression of intracellular ALP (12.80 ± 3.62), Runx2 (6.61 ± 0.48) and osterix (21.42 ± 1.56), and the differences were statistically significant (all P< 0.05), while 20.0 mg/L inhibited the expression of ALP (0.88 ± 0.17), OCN (0.16 ± 0.05) and osterix (1.35 ± 0.51), and the differences were statistically significant (all P<0.05). Compared with the 0.0 mg/L group [1.36 ± 0.58 (IRE1), 0.96 ± 0.45 (Xbp1)], the expression of endoplasmic reticulum stress related genes IRE1 [14.84 ± 2.57 (2.0 mg/L), 4.10 ± 0.52 (8.0 mg/L), 5.30 ± 0.63 (20.0 mg/L)] and Xbp1 [2.62 ± 0.66 (2.0 mg/L), 1.97 ± 0.47 (20.0 mg/L)] were significantly increased in the corresponding fluoride groups (all P<0.05). After IRE1 gene knockout, compared with the control group [gene:3.25 ± 0.48 (OCN), 5.62 ± 1.86 (Runx2), 2.67 ± 0.35 (ALP); protein: 0.16 ± 0.03 (OCN), 0.34 ± 0.27 (ALP)], the gene expression of OCN [0.63 ± 0.46 (2.0 mg/L), 0.81 ± 0.36 (8.0 mg/L), 0.62 ± 0.31 (20.0 mg/L)], Runx2 [0.18 ± 0.03 (2.0 mg/L), 0.12 ± 0.01 (8.0 mg/L), 1.09 ± 0.33 (20.0 mg/L)] and ALP [1.01 ± 0.12 (8.0 mg/L), 0.38 ± 0.09 (20.0 mg/L)] in the corresponding fluoride groups were significantly decreased (all P < 0.05), protein expression of OCN [0.06 ± 0.02 (2.0 mg/L), 0.06 ± 0.02 (8.0 mg/L), 0.07 ± 0.03 (20.0 mg/L)], and ALP [0.02 ± 0.01 (8.0 mg/L), 0 (20.0 mg/L)] were significantly decreased (all P< 0.05). Conclusion Unfolded protein response is observed under different doses of fluoride in osteoblasts, and IRE1 gene knockout has inhibited the expression of ALP, OCN, osterix and Runx2 in osteoblasts induced by fluoride, which suggests that IRE1 signaling pathway may play a key role in the differentiation of osteoblasts exposed to fluoride.

Objective Our study was performed to design a drug-sustained capsular tension ring (CTR) to evaluate its potentiality on prevention of PCO in the swine capsular bag model in vitro.Methods Following the continuous capsule curvilinear capsulorhexis ( CCCC),Phacomulsification with capsular tension ring implantation was pedormed.CTR-supported swine capsular bag models were prepared and divided into two groups,group CTR ( n =13 ) implanted with the original CTR without any modification and group CTR-PLGA-MG132 ( n =13) implanted with the CTR covered with PLGA and MG132.The CTRsupported capsular bags were cultured in vitro for up to 3 weeks.The area of lens epithelial cells (LEC) coverage over the posterior capsule surface was quantified every day under microscope.The capsules were treated for histological examination.The change of fibronectin was assessed by ELISA assay kit.Results After 2 ～ 3 days,outgrowth of LEC across the posterior capsule was observed,and the posterior capsule was totally covered by a confluent monolayer of cell after (9.06 ± 1.61 ) days in group CTR.Capsular wrinkles became increasingly apparent as time progressed.An increase in capsular thickness was also observed.In contrast,there was less LEC deposition in group CTR-PLGA-MG132.Histological examination showed LEC layers were closely arranged on the posterior capsular surface in group CTR.In group CTR-PLGA-MG132,there was comparatively looser cell arrangement.Compared with group CTR,the mean fibronectin level of posterior capsule by week 3 in group CTR-PLGA-MG132 was 25.14 μg/ml and 106.09 μg/ml respectively.Statistical analysis showed a significant difference ( P ＜ 0.01 ).Conclusions LEC migration,proliferation,and synthesis of EMT markers were inhibited in Group CTR-PLGA-MG132,compared with Group CTR.Drug-sustained capsular tension rings can effectively inhibit the migration,proliferation of LEC and the change of EMT ( epithelial-to-mesenchymal transition) in swine capsular bag models.Drug-sustained capsular tension rings might be a potential therapy to prevent the posterior capsular opacification in the future.

Cystic lesions of the liver are classified into parasitic and non-parasitic lesions. Parasitic lesions mainly refer to hepatic cystic echinococcosis, and non-parasitic lesions can be further classified into benign, borderline, and malignant lesions. At present, there are still no comprehensive standard treatment of cystic space-occupying lesions in the liver. With reference to related literature in China and foreign countries, this article reviews the etiology, clinical manifestations, and diagnosis and treatment of hepatic cystic diseases, so as to improve the understanding of this disease.

Objective To investigate the predictive value of metabolic syndrome (MS) on new-onset cholelithiasis.Methods The retrospective cohort study was conducted.The data of 89 553 subjects who participated health examination at the Kailuan General Hospital Affiliated to the North China University of Science and Technology,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Jinggezhuang Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from June 2006 to December 2015 were collected.According to the diagnostic criteria of MS published by International Diabetes Federation,all the patients were divided into 4 groups,including 70 657 without MS in the normal group,14 075 corresponded with 3 diagnostic criteria of MS in the MS-3 group,4 556 corresponded with 4 diagnostic criteria of MS in the MS-4 group and 265 corresponded with 5 diagnostic criteria of MS in the MS-5 group.Health examinations were applied to all subjects by the fixed team of doctors at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) comparisons of clinical characteristics among the 4 groups;(2) incidence of cholelithiasis in the 4 groups;(3) risk factors analysis affecting new-onset cholelithiasis.Measurement data with normal distribution were represented as (x) ± s and comparisons among groups were analyzed using the one-way ANOVA.Pairwise comparison and homogeneity of variance were done using the LSD test.Heterogeneity of variance was done using the Dunnett's T3 test.Measurement data with skewed distribution were described as M (Q) and comparisons among groups were analyzed using the nonparametric Kruskal-Wallis test.Comparisons of count data were analyzed by the chi-square test.The incidence of cholelithiasis in the 4 groups were calculated by the Kaplan-Meier method and comparisons of incidence were done by the Log-rank test.The COX proportional hazards model was used to analyze the hazard ratios (HR) and 95％ confidence interval (95％ CI) of MS on new-onset cholelithiasis.Results (1) Comparisons of clinical characteristics among the 4 groups:age,sex (male),systolic blood pressure (SBP),diastolic blood pressure (DBP),waistline,triglyceride (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),fasting blood glucose,BMI,cases with hypertension,diabetes,drinking,smoking and physical exercise were (50± 12) years,52 895,(127 ± 20) mmHg (1 mmHg =0.133 kPa),(81 ± 11) mmHg,(85±9)cm,1.14 mmol/L (range,0.83-1.56 mmol/L),(4.9±1.1) mmol/L,(1.56±0.39)mmol/L,(5.2± 1.3)mmol/L,(24.5±3.3) kg/m2,24 016,7 696,11 636,20 689,10 245 in the normal group and (54± 11)years,12905,(142±19)mmHg,(90±11)mmHg,(94±8)cm,2.08 mmol/L (range,1.51-3.04 mmol/L),(5.1±1.3)mmol/L,(1.50±0.42)mmol/L,(6.3±2.1)mmol/L,(27.1±3.2) kg/m2,10 031,5 737,3 090,4 762,2 353 in the MS-3 group and (54±10)years,4 556,(146±19)mmHg,(92±11)mmHg,(97±7)cm,2.57 mmol/L (range,2.03-3.80 mmol/L),(5.2± 1.4)mmol/L,(1.44±0.45)mmol/L,(7.2±2.4)mmol/L,(28.1±3.1)kg/m2,3 696,2 971,1 091,1 699,867 in the MS-4 group and (56±11)years,265,(146± 17)mmHg,(92±11)mmHg,(98±6)cm,2.60 mmol/L (range,2.06-3.91 mmol/L),(4.9±1.1)mmol/L,(0.86±0.14) mmol/L,(7.7± 2.9) mmol/L,(28.7 ± 2.9) kg/m2,221,196,62,93,78 in the MS-5 group,respectively,with statistically significant differences among the 4 groups (F =481.40,x2 =3 359.07,F =3 551.06,3 280.16,5 915.20,x2 =18 358.71,F=211.30,473.42,4 168.34,3 909.75,x2 =9 829.51,14 449.74,375.78,225.14,145.73,P ＜ 0.05).(2) Incidence of cholelithiasis in the 4 groups:89 553 subjects were observed for (8.0± 1.1) years,and 4 313 had new-onset cholelithiasis with a cumulative incidence of 4.8％.The cumulative incidences of cholelithiasis in the normal,MS-3,MS-4 and MS-5 groups were respectively 4.5％,5.6％,6.3％ and 13.2％,with a statistically significant difference among the 4 groups (x2 =89.96,P＜ 0.05).There were statistically significant differences in the cumulative incidences of cholelithiasis among the normal,MS-3,MS-4 and MS-5 groups (x2=28.56,29.25,43.48,17.13,35.75,16.82,P＜0.05).(3) Risk factors analysis affecting new-onset cholelithiasis:results of COX proportional hazards model showed that hazard of the new-onset cholelithiasis in the normal group was increased compared with that in the MS-3,MS-4 and MS-5 groups with adjustment for sex,age,high-sensitivity C-reactive protein,smoking,drinking and physical exercise (HR=1.16,1.33,2.68,95％CI:1.07-1.26,1.17-1.51,1.92-3.74,P＜0.05).Conclusion MS is an independent risk factor of new-onset cholelithiasis,and the increased incidence risk of new-onset cholelithiasis is consistent with subjects corresponded with diagnostic criteria of MS.

Objective To investigate the postoperative complications of ex vivo liver resection combined with autologous liver transplantation in the treatment of end-stage hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies. Methods Surgical data and follow-up data were collected from 11 patients with end-stage hepatic alveolar echinococcosis who underwent autologous liver transplantation in Qinghai People's Hospital from January 2013 to March 2019, and intraoperative and postoperative conditions were analyzed. Results All 11 patients underwent autologous liver transplantation successfully, without intraoperative death, among whom 2(18.18%) underwent hemi-extracorporeal hepatectomy and 9 (81.82%) underwent total extracorporeal hepatectomy. For the reconstruction of the retrohepatic inferior vena cava, 2 patients (18.18%) underwent reconstruction with the autologous great saphenous vein, 4 patients (36.36%) underwent reconstruction with artificial vessels, and the autologous retrohepatic inferior vena cava was preserved in 5 patients (45.45%). For biliary reconstruction, 8 patients (72.73%) underwent choledochoenterostomy and 3 (27.27%) underwent choledochocholedochostomy. The main postoperative complications of the 11 patients included bleeding in 2 patients (18.18%), bile leakage and abdominal infection in 4 patients (36.36%), bilioenteric anastomotic stenosis in 1 patient (9.09%), thrombus in 2 patients (18.18%), pulmonary infection and pleural effusion in 2 patients (18.18%), and echinococcosis recurrence in 1 patient (9.09%). Of all 11 patients, 2 (18.18%) died during the perioperative period, and the other 9 patients (81.82%) were improved and discharged. Conclusion Bleeding, biliary complications, and infection are the main causes of death in patients undergoing autologous liver transplantation at high altitude. An accurate understanding of surgical indication, careful multidisciplinary evaluation before surgery, superb operation during surgery, standardized surgical procedures, and fine perioperative management are the key to reducing perioperative mortality, avoiding and reducing postoperative complications, and achieving good long-term survival in patients undergoing autologous liver transplantation.

Objective To analyze the expression of cyclooxygenase-2 (COX-2) in the patients with snow-white sign of advanced colorectal adenoma (ACA) and explore its clinical significance.Method Western blotting was employed to determine the expression of COX-2 in the adenoma tissue and the normal tissue adjacent to the adenoma tissue (>5 cm away from the distal end of the adenoma tissue) of 40 ACA patients with snow-white sign and 40 ACA patients without snow-white sign.Results The appearance of snow-white sign in ACA patients was associated with patient age (P=0.001) and not associated with sex,smoking history,drinking history,ethnic groups,family history of colorectal cancer,abdominal pain,diarrhea,constipation,fecal occult blood,or tumor markers (all P>0.05).Snow-white sign mainly appeared in the ACA patients with multiple adenomas (P=0.004),large adenomas (P=0.006),adenomas in distal colon (P=0.015),protruding polyps (P=0.044),and late-stage pathology (P=0.010).The occurrence of snow-white sign showed no difference in the ACA patients with different results of Japan NBI Expert Team classification (P=0.502).The expression of COX-2 in the adenoma tissue was higher than that in the adjacent normal tissue in the patients with and without snow-white sign (P<0.001,P=0.004).The patients with snow-white sign had higher expression of COX-2 protein in the adenoma tissue than the patients without snow-white sign (P=0.001).The expression of COX-2 protein in the adjacent healthy tissue had no significant difference between the patients with and without snow-white sign (P=0.603).Conclusions Snow-white sign is more like to appear in the ACA patients with young age,multiple and large adenomas,adenomas in distal colon,protruding polyps,and late-stage pathology.Moreover,the expression of COX-2 in the ACA patients with snow-white sign is significantly higher than that in the ACA patients without snow-white sign.The adults with snow-white sign are prone to cancerization than those without snow-white sign.
Adult ; Humans ; Cyclooxygenase 2 ; Snow ; Colorectal Neoplasms ; Adenoma

Objective To investigate the biologic viability and boundary range of hepatic alveolar echinococcosis (HAE) by the contrast-enhanced ultrasonography (CEUS) and acoustic radiation force impulse elastography (ARFI). Methods Totally 27 HAE patients confirmed by pathology underwent CEUS and ARFI examinations. Results Gray scale sonography of HAE showed unclear boundary, inhomogeneous, and middle hyperechoic nodules, and the maximum area was (6.08 ± 4.47) cm² in 27 lesions. CEUS of HAE showed non-enhancement in three phases and black hole sign. Circumferential enhancement on the pe riphery of the lesion was synchronized with the liver parenchyma and showed “fast in and slow out”. The maximum area was (8.87 ± 4.83) cm². The area of ECUS was larger than gray scale sonography in HAE (t = 2.20, P = 0.03). The mean shear wave velocities (SWVs) of the interior, the boundary range, and the surrounding liver tissues of HAE were statistically different by ARFI (F = 84.538, P < 0.001), and the interior had the highest values. Conclusions CEUS and ARFI examinations can detect the biologic viability and boundary range of migrating zone around HAE, which is valuable for guiding treatment, judging curative effect, and predicting prognosis.

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy characterized by simple operation and few postoperative complications have gradually become the two most commonly used surgical methods in clinical practice.A series of complications often occur after bariatric surgery,including gallstone disease,anemia,malnutrition,gastroesophageal reflux disease,kidney stones,and birth defects in offspring of women of childbearing age.There are controversies regarding the causes and countermeasures of these complications.This article mainly reviews the risk factors and countermeasures for the complications after bariatric surgery.
Humans ; Female ; Bariatric Surgery/methods* ; Gastric Bypass/methods* ; Gastroesophageal Reflux/surgery* ; Postoperative Complications/prevention & control* ; Risk Factors ; Gastrectomy/methods* ; Laparoscopy/methods* ; Obesity, Morbid/surgery* ; Retrospective Studies

The plateau zokor (Myospalax baileyi) and plateau pika (Ochotona curzoniae) are native species unique to the Qinghai-Tibetan Plateau with successful adaptation to the hypoxic environment. In this study, the number of red blood cells, hemoglobin concentration, mean hematocrit and mean volume of red blood cells were measured in plateau zokors and plateau pikas at different altitudes. Hemoglobin subtypes of two plateau animals were identified by mass spectrometry sequencing. The forward selection sites in two animals' hemoglobin subunits were analyzed by PAML4.8 program. Homologous modeling was used to analyze the effect of forward selection sites on the affinity of hemoglobin to oxygen. The adapting strategies of plateau zokors and plateau pikas to hypoxia at different altitudes were analyzed through comparing blood parameters between the two species. The results indicated that, with increasing altitudes, plateau zokors responded to hypoxia by increasing red blood cell count and decreasing red blood cell volume, while plateau pikas took the opposite strategies to plateau zokors. In erythrocytes of plateau pikas, both adult α₂β₂ and fetal α₂ε₂ hemoglobins were identified, while erythrocytes of plateau zokors only had adult α₂β₂ hemoglobin, however the affinities and the allosteric effects of the hemoglobin of plateau zokors were significantly higher than those of plateau pikas. Mechanistically, in the α and β subunits of hemoglobin of plateau zokors and pikas, the numbers and the sites of the positively selected amino acids as well as the side chain groups polarities and orientations of the amino acids differed significantly, which may result in the difference of the affinities to oxygen of hemoglobin between plateau zokors and pikas. In conclusion, the adaptive mechanisms to respond to hypoxia in blood properties of plateau zokors and plateau pikas are species-specific.
Animals ; Altitude ; Amino Acids ; Hemoglobins ; Hypoxia ; Lagomorpha